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Jingdong book

临床诊疗指南·妇产科学分册

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Books Medical Science Obstetrics and Gynecology

Jingdong book

临床诊疗指南·妇产科学分册

Name: 临床诊疗指南·妇产科学分册
Brand: Jingdong book
SKU: 3117041011
Price: 30.61 USD
Availability: OutOfStock

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Content Description

本指南共26章，分为妇科篇与产科篇。分别介绍妇产常见疾病的临床表现、诊断和治疗常规。内容力求简单扼要、重点突出，有较高的实用性和可操作性，能符合有同地区、层次和条件的医务人员和医疗单位的需要。
本指南尽力采用国际和国内最新的疾病分类、临床病种、诊断标准和治疗新进展，如盆腔器官脱垂，部分内容是首次见于我国妇产科学参考书。
本指南是妇产科临床工作者日常必备的参考书，可供各级妇产科医师、临床研究生、进修生及其他相关专业医参考，也是医疗行政管理人员评定技术质量的重要参考依据。

Catalogue

妇科篇
第一章外阴白色病变及外阴瘙痒
第二章下生殖道炎症
第三章上生殖道炎症
第四章性传播疾病
第五章妇科急腹症
第六章外阴阴道肿瘤
第七章宫颈肿瘤
第八章子宫肿瘤
第九章卵巢肿瘤
第十章输卵管肿瘤
第十一章妊娠滋养细胞疾病
第十二章子宫内膜异位症和子宫腺肌症
第十三章妇科内分泌疾病
第十四章有孕症
第十五章性分化发育异常及生殖道畸形
第十六章女性生殖器官损伤性疾病
产科篇
第一章产前保健
第二章正常分娩
第三章正常产褥
第四章妊娠期并发症
第五章妊娠合并症
第六章异常分娩
第七章产时并发症
第八章产褥期疾病
第九章产科B超
第十章妊娠期用药

Book Abstract

4.畸形子宫妊娠由于宫腔形态、宫腔轴向及子宫肌发育不良等原因，易发生胎位异常，以臀先露最多见，发生率高达25%～37.4%，其次为肩先露，可达2.9%～6%。
5.畸形子宫由于宫颈、宫体肌肉发育不良及胎位异常的发生率明显升高，妊娠分娩并发症也随之增多，常见有胎膜早破、宫缩乏力、子宫破裂、产后胎盘滞留及产后子宫迟缓出血等。
6.双子宫妊娠时，非孕侧子宫也呈现反应性增大，偶见增大的另一侧子宫阻塞产道而发生阻塞性难产。
7.双子宫一侧子宫妊娠，由于两侧各韧带的紧张度失去固有的平衡，一旦腹压增加或遇外力，可使子宫发生急性扭转，临床表现近似卵巢囊肿蒂扭转，但较为罕见。
8.畸形子宫妊娠由于子宫腔的形状不规则或狭小，可使胎儿活动受限；另外因子宫发育不良也可使子宫肌血液供应不良，这些都会使胎儿在宫内生长发育受限，胎儿窘迫、死胎、死产及新生儿窒息的发生率也因之增加。
【诊断要点】
1.畸形子宫妊娠与正常子宫妊娠相似，早期有恶心、呕吐反应，中期出现胎动及子宫逐渐增大，由于缺乏特异性症状其诊断极易被疏漏。必须注意病史，要了解孕前有无月经量过多、痛经及不孕等症状，了解有无流产、早产等不良妊娠分娩史，如有上述情况应首先考虑有子宫畸形的可能。
2.妊娠12周以前，初诊建立保健册时应常规做阴道检查，如发现双阴道双子宫颈或单阴道双子宫颈，则考虑双子宫一侧妊娠，进一步做双合诊检查，可见两个宫体，一大一小，呈分叉状，则诊断即可确立。可疑时可借助B超检查确定诊断。超声波横切扫查时，其声像特点是子宫呈眼镜形，一侧为具有妊娠囊及胎儿的子宫，另一侧具有增厚的子宫内膜，宫腔中间可见高辉度的线状回声。
3.产前检查时应仔细检查子宫轮廓、胎产式及胎方位。如宫底部向内凹陷，宫底一角凸出，呈马鞍形，应考虑为双角子宫妊娠，如宫底向内凹陷程度较轻，略呈弓状者则为弓形子宫。双角子宫因宫腔形状改变常伴发胎位异常，以臀位或横位较多见，如产前疑为双角子宫妊娠时，产后应探查宫腔以明确诊断。
4.中隔子宫的外形完全正常，仅在宫腔内有一完全或不全中隔，单凭阴道检查无法诊断，多因不孕、反复流产或早产行宫腔镜检查或子宫输卵管造影时始被发现。如能继续妊娠常出现臀位或横位等胎位异常，附着于纵隔处的胎盘剥离易发生障碍，产后出血较多，因胎位性难产行剖宫产或因胎盘滞留行手法剥离胎盘探查宫腔时，发现完全或不全中隔方能确定诊断。
5.单角子宫妊娠比较罕见，单角子宫系一侧副中肾管停止发育所致。单角子宫肌壁发育不良，宫腔也较狭小，故怀孕后流产、早产多，臀位多，分娩期子宫破裂多。孕期诊断困难，仔细检查可发现子宫偏向一侧，子宫与胎儿和母体腹部纵轴持续性呈斜的交角，难以矫正，但确定诊断还需在剖宫产直视下检查子宫。
……

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